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Home My WebLink About16226-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16142 Date September 8, 1987 THIS CERTIFIES that the building ACCE S S ORY SHED Location of Pro eft 2065 Minnehaha Blvd. Southoid, New York House No. Street Hamlet County Tax Map No. 1000 Section ...0. 8..7 ...... Block ...0.3. .......... Lot 54 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 10, 1987 16226 z ...................... pursuant to which Building Permit No ...................... dated Su I y 14, 1987 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ACCESSORY SHED The certificate is issued to PATRICK W. LOHN & NORTH FORK BANK & TRUST CO. ..................... ?oYn'o;,'~g~¥¥grXtgC$Th~t ..................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. pLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 TOWN OF $OUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZ£D) N~16226 Z Permission is hereby gronted to: .... ~. ~o.q. II '1 County Tox Map No. 1000 Section ...... ..(~...~....~ ....... Block ...... ..(~.....~ ..... Lot No....~..1~. ............. Building Inspector. and opproved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 TOWN OF So~ ~ ~c,[ ~' Instructions ~' [~~ This application must be filled in typewriter OR ink, and submi~ed ~ ~ to the Building In~ec- tor with the following; for new buildings or new use: 1. Final su~ey of property with accurate location of all buildings, property lines, ~reets, and unu~al natural or topograph'ic fea~res. 2. FinaJ approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Unde~riters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and in~alla- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa~ tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, ~ I$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0-. 0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 !/ ~..? 5.Updated C.C. $ 50.00 Date .... ~..~. ...-- .......... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~/F.,~ .... /fVrA)~ /~V , House No. Street Hamlet ....................... Owner or Owners of Property f/) ........... ' ............... /~z~r/¢_~ ~/~'.~./}/V. ~,~ '..~-~.~-~:L County Tax Map No. 1000 Section ~Y Block .~,'~. Lot . . '~..t~. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No J.~"~ Data of Permit ?ji,~./,~'.7, .Applicant Health Dept Approval .~J~. ................... Labor Dept Approval ~]~ ..................... Unde~ri~ers Approval ~J~ ..................... Planning Board Approval N/~ ................... flequest for Temporary Certificate .~].~ ..................Final Certificate . N/8 ................... Fee Submitted $...1~. 7 ....................... Construction on above described building and per/~nit meets all applicable codes and regulations. Applicant .. . .................. Rev. 10-10-78 UNDATION (1st) UNDATION ( 2nd ) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] I~ULATION / FRAMING [//]' FINAL REMARKS: DATE: ,INSPE(~TOR ~,~c~ ~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved4~ ./.q.., 19~?. Permit No..[/4.'~..~r..h'. .~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS FOR~ ............. : BOARD OF HEALTH 3 SETS OF PLANS SURVEY .~ ....... CHECK SEPTIC NOTIFY CALL ................ MAIL TO a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets ef p!an*,, ~¢ur,~to, plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance oF a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances m Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buCt~ing code, housi2ag code, and regulations, and to admit authorized inspectors on premises and in building for necessary~ ~~f hcant, or name, if a corporation) .... ,.. · (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~.~~1 ' '' . .~.-.T'.Pr./V '!~.~. d..' .~..l.'/./~.. ~rn)b ..... ~.thg.~/..~.~*i~5~/~,. ff.~ .,,,..' (as on the tax roll or latest deed) ct, raj r,'tgtJt' ¢6, If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ....... ~/t ............... Plumber's License No ..... P~I fl ................ Electrician's License No .... .~. I./ll ............... Other Trade's License No .... ' .ff4[/'5 .............. 1. Location of land on which proposed work will be done .................................................. .o7. ......... #.4 ................... q.,:..3 ...... ............. House Number Street Hamlet County TaxMap No. 1000 Section ...~.7 ............ Block .... P ............ Lot..~.~-7 ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~,~h~-~ .~..~.~.~.P~ -- ...................................... t .......... b. Intended use and occupancy .... .~..~..~. ~:l.~.~...~T/QI~t20~g~JF~..-. :~.~...~/v..~.~. ~d.'. · ~ ......... 3. Nature of work (check which applicable): New Building ......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. EstimatedCost..~.~../~.&i. .......... Fee......(~5.~. .......................... " (to be paid on filing this application) 5. If dwelling, number of dwellingi,units..~/.~. ......... Number of dwelling units on each floor ................ If garage, number of cars ...~[~ ........................................................ 6. If business, commercial or mixed occupancy, spec/fy nature and extent of each type of use :...t-~. ]~ ............ 7. Dimensions of existing structures, if any: Front..t~/~ .......... Rear .............. Depth ............... Height Number of Stories Dimensions'of same structure With alterations or additions: Front ................. Rear .................. Depth ................... ,... Height ...................... Number of Stories ......... ;D .......... 8. Dimensions of entire new construction: Front .... 10.t...' ..... Rear .. t CIr. ........ Depth . I .'-r. ........... Height ............... Ih!umber of Stories .... J ........... ' ........................................ Size of lot: Front . .t..~..q- ·. ! ............ Rear .... }.2. r~ ............... Depth . .j].. .................. 10. Date of Purchase /.¢ ~i'/~./~[. .............. ,~... Name of Former Owner . .:~7"~-~AJ./~.. ~.~l:{P:J ........... I 1. Zone or use district in whidh premises are situated/~..-. ,~,5..i.'P.~.~."O.~. L ...................................... 12. Does proposed construction vi.elate any zoning law ordinance or regulation' />30 13. Will lot be regraded ..... ~'/~.~. ................... Wilt excess fill be removed from premises: Yes _ No 14. Name of Owner of premises ~Tg~.: ~ljtJ~{.~ .~y~.~..M..~! ~I~i~ss~.~.5_~ .l~t~~ '.~].t-.l//3. Phone No~f~/~.~?~'.~.:~ .~.J'.~. ' Name of Architect ......... i ............ Address ...... Phone No .......... Name of Contractor ........ ! .................. Address ...................Phone No. . :: ........... 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No *If yes, Seuthold Town Tr Locate clearly and distinctly al property lines. Give street and bloc~ interior or corner lot. ~stees Permit may be required. PLO~ DIAGRA~ [build,ts, whether existing or proposed, and. indicate ~ls~t-back dimensions ~om numberordesc~ptionaccordingto deed, andshow streetnamesandindicate whether STATE OF NEW YORK, I S.S COUNTY OF ................. , ...... {4a lflad 5 ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Itc is the (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is d~ly authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~n~r set forth in the application filed therewith. Sworn to before me this ...... County No. ~o9 ~ (Signature of applicant) T~ E~I~ In~. ~, ,u~